Health and Social Care Budgets — [Mr Adrian Bailey in the Chair]

Part of the debate – in Westminster Hall at 9:51 am on 14th March 2017.

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Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot 9:51 am, 14th March 2017

I shall be brief, Mr Bailey.

Our NHS is the envy of the world; our social care system, frankly, is not. Much has changed since the war years, and that has not yet been reflected or accepted. The health budget of £120 billion sounds a lot, but it is inadequate. It assumes that demand is falling; it is not, it is rising. Even NHS England has admitted that it is not enough. It is not sustainable—that is what the Public Accounts Committee report has set out. Trusts are still in deficit. Clinical commissioning groups have a very varied outcome, financially. The GP triaging offer is welcome, but it is a drop in a proverbial ocean.

The move to sustainability and transformation plans is absolutely right; the problem is that it is not properly funded and we are considering implementing models of care that are untried, untested and uncosted. That cannot be right. There is no transition funding and, although I welcome the capital funding for the project, £325 million is, I am afraid, not enough, Minister. Social care represents a third of local authority spending. We currently spend £14.4 billion. Unlike with the NHS, it is means-tested. Again, demand is going up but the funding is going down.

The funding to local government is inadequate. The 3% precept is helpful, but those of us in rural areas clearly have to pay more because we pay more council tax overall, compared with input from the state. The £2 billion is very welcome, but as my neighbour, my hon. Friend Dr Wollaston, explained, it is a little bit but not enough and we need a proper review. We must also ensure that that money does not get stuck with our local authorities. That has happened before and I would not be happy with its happening again.

On the big picture, we do not really measure the system. We do not look at, or measure, need. We do not look at the people who do not even ask for help. Until we start measuring input, output and outcomes across the whole of health and social care, we will not solve the problem. The Green Paper is extremely welcome, and I agree with my hon. Friend the Member for Totnes that it must cover both health and social care. It would be better than a commission, but it must look at the whole system. It must look at the free/means-tested issue. It must look at integration, joint commissioning and a joint budget and accept some structural changes. We have had Sutherland, Wanless, Dilnot and Barker; the issue really is not that simple.

The Government must face up to the problem, but the public also must play their part. We have to accept change, and that is not easy. We must, as others have said, look at general tax, hypothecated tax, insurance, compulsory saving and much more, but the issue is not about just money, but models of care. While we are at it, Minister, please could we have some fair funding for rural areas? We have a disproportionate number of over-85s and rural sparsity that is not properly dealt with. Please Minister, can we have honest acceptance of the problem and the will to face up to it?